This blog is made to share news on Alzheimer’s Disease in India. To raise awareness among the population in and from India, inform people of the resources they may have in their country and about actions taken by organizations. Also, it aims to support families and caregivers there to cope with this disease; help researchers worldwide and advocates in collecting datas and infos, develop views on the local Public Health Policy toward the affected elderly population in India.

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Thursday, April 19, 2007

April 26, 2005Can curry slow down Alzheimer's?Can’t decide whether to eat Indian, Chinese or Continental? You'll probably have a yearning for a bit of chicken tikka masala or rogan josh after reading this: A study by University of California, Los Angeles-Department of Veterans Affairs, shows how turmeric, one of curry's key components, may be effective in slowing down the progression of Alzheimer's disease and possibly even curing it.

The study was conducted on genetically altered rats fed on foods flavoured with copious amounts of turmeric. Turmeric is rich in curcumin, a compound known for its antioxidant and anti-inflammatory properties. The discovery that curcumin may prevent the accumulation of destructive beta-amyloid plaques in people suffering from this degenerative brain disease and also break up existing plaques, probably explains why the incidence of Alzheimer’s in India is the lowest in the world.

As compared to other medications being tested on Alzheimer’s patients, turmeric appears to be more effective, possibly due to the structure and low molecular weight of curcumin that enable it to penetrate the blood-brain barrier. Human clinical trials to further evaluate the possible protective and therapeutic effects of curcumin are now on the anvil. So while scientists and researchers hunt for an allopathic cure, let’s give traditional wisdom a chance—spice up your taste buds with Indian curry and protect your brain cells.

NEUROLOGY India,Some observations on the spectrum of dementiaYear : 2004 Volume : 52 Issue : 2 Page : 213-214Diagnostic appraisal of dementia needs an optimistic approach for the benefit of the physician and the patient. With the advancement of new diagnostic tools it is easy to classify dementia into definite clinico-pathological groups. Epidemiological data about dementia appear conflicting as till the 80's MID was reported to be more prevalent than AD in Japan, Korea and China but in the 90's AD was documented as being twice as common as MID in these very countries.[3] AD has been consistently reported to be the commonest type of dementia by American and European studies.

We observed that AD, which is irreversible and common in the west, is uncommon in India. Similarly, prevalence of AD in Nigeria has also been observed as low.[3] Initially, it was attributed to poor suspicion, but in spite of adopting the NINCDS-ADRDA criteria,[2] we observed that about 75% patients in our study had a potentially treatable etiology or in whom progress of dementia could be halted. MID, infections, poorly distilled country-made liquor were other common yet treatable causes and so was nutritional dementia.

Most of the Indian studies have also reported MID to be more prevalent. In the first epidemiological study from the Indian subcontinent, the incidence of AD was reported to be amongst the lowest possible.[4] Explanations forwarded by the authors were short duration of follow-up, cultural factors and other potential confounders.

In a similar study in rural northern India an overall prevalence of AD has been described as very low (0.62% in the population over 55 years and 1.07% in those aged 65 and above). Of course this prevalence increased with age. Explanations postulated were low overall life expectancy, short survival with this disease and low age-specific incidence, potentially due to differences in the underlying distribution of risk and protective factors as compared with populations with higher prevalence.

[5]A community-based study in a rural population in Kerala reported 58% of patients with MID compared to 41% with AD. There were more women and positive family history was prominent in the AD group. Smoking and uncontrolled hypertension was associated with MID.

[6] A few Indian studies are also contradictory, with AD being suggested to be more prevalent than MID.[3] Interestingly, in another report from India the prevalence of dementia was observed to be higher in the rural population as compared to the urban settings.

[7]There is a difference in the incidence and prevalence of AD between underdeveloped and developed countries. Many interesting reasons have been cited. The widespread use of pesticides and the type of smoking has been directly correlated with MID, which is more prevalent in India. Another reason forwarded is the widespread use of electric lighting. Exposure to bright light suppresses the secretion of melatonin, a free radical scavenger, which inhibits progressive formation of beta sheets and beta amyloid fibrils. Its production is further reduced with aging, thus increasing susceptibility to age-related diseases like AD.[8]

If elderly people have a problem with their memory is it possible that they may be developing Alzheimer's disease.(अल्ज्हेइमेर'एस दिसेअसे). Part 1 / पार्ट १ .Simple forgetfulness should not be confused with memory loss due to a disease।

The American Alzheimer's Association has developed these "10 warning signs" to look for to see if a person maybe developing this disease।1।Is memory loss affecting job skills?2।Does it affect the ability to perform familiar tasks?3।Are there problems with language, such as finding the right words for familiar objects?4।Is there frequent disorientation as to where and what time of day it is?5।Is judgment poor or decreased?6।Are there consistent problems with abstract thinking?7।Are familiar objects frequently misplaced?8।Are there noticeable changes in mood or behavior?9।Are there noticeable changes in personality?10।Is there a loss of initiative?

If these are the signs then one should consult and take the advice of the most experienced physician possible।Alzheimer’s disease is not the only cause of memory loss and / or confusion। Other disorders, including depression, reactions to certain drugs, a series of small strokes (called multi-infarct dementia), hearing problems, vitamin deficiencies, and certain tumors and infections may look just like Alzheimer’s disease to friends and relatives, but are much more treatable।

Part 2 / पार्ट २

Have you often gone into a room and wondered why you came there in the first place? Do you frequently "misplace" your keys?Do not blame it on "Old Age"।Here are some things you could do to get over simple forgetfulness।

१) Make a place in your house to put those things you frequently misplace। Make it a point to always keep your keys, wallet, ration card, milk card etc. in that place.

२) Though some things are better done by routine, try to do things differently, which will encourage the brain to work, and break the monotony। For example take a simple detour to reach the same place. Button your shirt from down to up. Read the newspaper from the last page.

३) Start using a note pad to jot down things you have to do, or phone numbers, details of bills and so on। Try to always carry this pad and a pen with you.

४) Organise yourself and get into the habit of putting things in their places। For example if you use a pair of scissors and forget to put it back, you may have to spend a lot of time looking for it.

५) Do not postpone anything that can be done just then। That way you will not have a chance to forget to do it.

६) While doing something you need to remember later, repeat to yourself that you are doing it। For example if you have deposited a cheque in the bank, tell yourself more than once "I have deposited the cheque in the bank". Even if you have to do somethimg you could say to yourself more than once "The electricity bill has to be paid tomorrow".

७) If you have to do something important, remember to leave reminder notes for yourself in places you will not miss seeing।

८) If you find yourself in a room wondering why you came there, try going back to the place where you came from। This usually brings back your memory.

९) Create a mental picture of what you have to do. For example if you have to pick up your grandchild from school, imagine the scene where you are picking him up and bringing him home. This kind of visualisation helps you remember.

Thursday, April 12, 2007

An elderly parent who was hale and hearty and quite well for her age, was suddenly reported deceased.

If taking people for a ride is deplorable, it is more so when those being ripped off are dependents. The elderly and aged, for instance. A look at some of thehomes for the aged that have mushroomed around Bangalore shows that one needs to make careful investigations and check details first, before choosing one, either for oneself or for one’s parents.

Thanks to factors like rising longevity, the disappearance of the extended family pattern of living, and children moving away as NRIs, there is a rising demand for old age homes.

An information directory brought out by the city’s Elders Helpline lists over 60 such homes, with charges ranging widely from Rs 700 to Rs 3,500 per month (and deposits of anything from Rs 10,000 to over one lakh and forty thousand). Some are also free, but in spite of the proliferation of homes for the aged we don’t yet have any regulatory body or legislation to protect the interests of those living in such places. With the result that there are reports of shady operators who collect money but do not provide proper facilities.

At least one such operator is reported to have moved from one place to another, setting up ‘homes’ and making money out of the enterprise at the expense of the aged.

The most common stories I heard pertained to medical bills. A doctor is often available for consultations once or twice a week, but some inmates have been asked to undergo unnecessary tests (for which extra payment has to be made) and that too, only at particular labs recommended by the doctor. In one case, a woman in her sixties was told that she should have expensive tests done for checking her heart. The receptionist at the clinic (perhaps a new appointee !) naively asked the , when she turned up with her report, if she was having respiratory or other problems, and when she said no, she was feeling fine, the girl at the counter wondered, “Then why have you been asked to go for an echo-cardiogram ?” The woman had herself wondered - but with age, physical infirmities, both apparent and hidden, become scary bogies, and unscrupulous staff take advantage of this, to scare the elderly into paying for extra tests.

In another case, the deposit which was supposed to be refundable, was returned after heavy deductions, with the explanation that the charges were “for medicines”. A doctor associated with an NGO who checked the details of the charges, says it is doubtful if one person could have consumed so many medicines in the course of just four weeks as the home claimed. There were also no proper receipts for purchases, no chemists’ bills or even doctor’s official prescriptions, only scraps of paper with lists of drugs purportedly given. The aged inmate , when queried by the family, could not remember whether all these medicines had indeed been consumed.

In yet another case, an elderly parent who was hale and hearty and quite well for her age, was suddenly reported deceased, and the family was informed only after the lapse of two days. Why the delay, and why was the body sent for post mortem before the relatives were informed ? No proper explanations were forthcoming. The children of the deceased are even wondering if the organs were intact in the body, and whether there could be a racket of sorts. Nothing could be proved, however, and even the police declared that there was insufficient evidence to book a case.

Common complaints are about :insufficient or unsatisfactory food, and lack of facilities promised on paper. It is common practice to have no written agreements at the time of admission, listing rules and entitlements. Some homes deduct 10 per cent of the deposit for each year of stay although technically the deposit is ‘refundable’. Cases have been known of homes for the aged printing ‘donation coupons’ of small denominations (Rs 5, 10, which are affordable and do not call for scrutiny) and selling these by the roadside to collect money (which does not always go to benefit the inmates). Sometimes, those running such operations claim political connections, and so action against them is tardy or stalled. Dr Radha Murthy of The Nightingales Medical Trust offers some suggestions for those who are contemplating admissions into old age homes.

A booklet, published by the Elders Helpline is available free of cost, listing details of several homes and the facilities they offer, the charges etc. Take a look.Visit the place you have in mind, check out the credentials, and talk to the inmates. If you are not allowed access, for discussions, be wary because there might be something to hide that the people in charge do not wish to make known.

Not only the families which are thinking of admitting their elderly members but also senior citizens too should educate themselves- about medical ailments connected with old age, coping strategies, for example - and exercise their right to information and right to choice.

Check the location of the home, the availability of hospital or clinical facilities nearby in an energency, the nursing services offered or promised, the type of food given, facilities for pastimes, security arrangements, facilities for accompanying the elderly if they need to go to the bank or post office etc.Get details in writing, rather than mere oral assurances.

And finally, a piece of advice from an inmate of a home for the aged - “How happy and contented you are, in an old age home, depends partly also on your own attitude,” she says. “Cultivate interests to keep yourself occupied, develop serenity, think positive, and grumble less. If there are issues to be addressed, do it without feeling that you are being victimised. Also, if you are healthy and mobile, reach out to the other inmates who may be less fortunate.”

That would be good advice for anyone, not merely for the aged. To that, another elderly inmate adds some advice for the children too - “If admitting your parent in a home for the aged is unavoidable , do not think that your duties end with paying the money. Make the effort to keep in touch, even if you are a NRI, visit as often as possible, and provide inputs that help fight the sense of abandonment that is often inescapable in an institution of this kind.

Pinch of salt:You might think that buying an expensive multinational brand guarantees quality. Not necessarily, however, as one customer realised after paying Rs 400 for a watch strap at Safina Plaza, and seeing it fray within three weeks. The shop not only refused to accept a complaint from her but was even abusive, declaring that she “did not know how to wear a watch sufficiently loose.” For that price she could have bought a decent watch, not just a strap. Check regarding guarantees offered,in writing, if you are paying for something expensive.

Wednesday, April 11, 2007

New Delhi - Sitting in the winter sun at an old-age home in Tilak Vihar in west Delhi, 71-year-old Veermati Devi is recovering from the shock of being thrown out of her home by her son and daughter-in-law.

'They were tormenting and harassing me all these months, saying I was useless and there wasn't enough space in the flat for me,' she says bitterly.

'It was better to take shelter at bus-stops than to suffer indignity...I don't want to go home now,' said Devi who endures a penniless existence in her twilight years.

Through the centuries Indian society has stressed deference and respect for elders, taking care of ones parents in their old age and the importance of living in a joint-family, however, there has been a perceptible erosion of these values as the country modernizes and embraces individualism and consumerism.

Perhaps more alarming are the frequent media reports on mental and physical abuse of parents by their children.

Manju Varshney who manages old-age homes says a majority of her clients were shown the door by their children - many before the ink dried on the transfer of property into their name.'Some even suffered physical assault and were pushed, shoved or slapped in their own homes,' she said.

Down south in Bangalore city, Subodh Keskar, 66 was left in a lurch when his only son left him to take up a job in an IT firm in the US three years ago.

The Keskars were relatively fortunate in having found a 'family' in Non-Resident Indians Parents' Association (NRIPA), a support group having over 250 members, many of whom were struggling with the 'empty nest syndrome.'

'We find understanding and emotional support as all of us face the same predicament' Keskar said.

Forces of migration and urbanization are upsetting the Indian value systems as thousands of young Indians emigrate to Western countries or to other Indian cities for better employment opportunities, resulting in the mushrooming need of support groups.

'More such groups are needed as a number of parents have similar issues. After requests from different places, we are considering forming an all-India body and associations in a dozen cities,' NRIPA founder Ambuja Narayan said.

Lack of financial security, 90 per cent of India's estimated 80 million seniors over 60 have no social security, and healthcare are just a few of the issues facing India's growing elderly population.

'We seem to be staring at a big crisis as after 2025, the number of elderly will increase from 8 per cent of the population to 15 per cent of the population,' said Mathew Cherian Chief Executive Officer, HelpAge, the biggest NGO working for the aged in the country.

The main trends of the aging population in South Asia are the greater concentrations of seniors in rural areas, impeding delivery of services, and the feminization of the elderly, according to Ghazy Mujahid, advisor to the UN Population Fund.

Women will shortly constitute over 52 per cent of the population above 60, in India, Nepal and Sri Lanka, a daunting number in places where few women are financially independent.

'There is a general disaffection toward the old which should change. We need to urgently focus on areas like nutrition, healthcare and spiraling costs of medicine, tax benefits and social security especially in the rural areas,' said HelpAge's Cherian.

All these factors are forcing the government to wake up and face the situation.GK Singh, Deputy Secretary, Social Justice Ministry, said under the Integrated Project for Older Persons, the government will construct an additional 340 old-age homes for the destitute-elderly, 220 day-care centres and 60 mobile medicare units across the country.

He added that the government will soon introduce the 'Welfare and Maintenance of Parent and Senior Citizens' legislation to protect the elderly.

Children and grandchildren not taking care of their elders could be jailed and aggrieved parents can approach tribunals to claim maintenance.

The legislation would also provide for the right of parents to revoke the transfer of property to their children in cases where the latter does not look after them.

Monday, April 9, 2007

Medical Studies/TrialsPublished: Tuesday, 28-Dec-2004A dietary staple of India, where Alzheimer's disease rates are reportedly among the world's lowest, holds potential as a weapon in the fight against the disease.

The new UCLA-Veterans Affairs study involving genetically altered mice suggests that curcumin, the yellow pigment in curry spice, inhibits the accumulation of destructive beta amyloids in the brains of Alzheimer's patients and also breaks up existing plaques.

Reporting in the Dec. 7, 2004, online edition of the Journal of Biological Chemistry, the research team also determined curcumin is more effective in inhibiting formation of the protein fragments than many other drugs being tested as Alzheimer's treatments. The researchers found the low molecular weight and polar structure of curcumin allow it to penetrate the blood-brain barrier effectively and bind to beta amyloid.

In earlier studies (Journal of Neuroscience, 2001; 21:8370-8377; Neurobiology of Aging, 2001; 22:993-1005), the same research team found curcumin has powerful antioxidant and anti-inflammatory properties, which scientists believe help ease Alzheimer's symptoms caused by oxidation and inflammation.

The research team's body of research into curcumin has prompted the UCLA Alzheimer's Disease Research Center (ADRC) to begin human clinical trials to further evaluate its protective and therapeutic effects. More information about enrolling in this and other clinical trials at the Center is available by calling (310) 206-3779 or online at http://www.npistat.com/adrc/Treatment.asp.

"The prospect of finding a safe and effective new approach to both prevention and treatment of Alzheimer's disease is tremendously exciting," said principal investigator Gregory Cole. He is professor of medicine and neurology at the David Geffen School of Medicine at UCLA, associate director of the UCLA Alzheimer's Disease Research Center, and associate director of the Geriatric Research, Education and Clinical Center at the VA Greater Los Angeles Healthcare System at Sepulveda, Calif.

"Curcumin has been used for thousands of years as a safe anti-inflammatory in a variety of ailments as part of Indian traditional medicine," Cole said. "Recent successful studies in animal models support a growing interest in its possible use for diseases of aging involving oxidative damage and inflammation like Alzheimer's, cancer and heart disease. What we really need, however, are clinical trials to establish safe and effective doses in aging patients."

The research was funded by the Siegel Life Foundation, Veterans Affairs, Alzheimer's Association, UCLA Alzheimer's Disease Research Center and private donors.

Alzheimer's disease (AD) is an irreversible, progressive brain disorder that occurs gradually and results in memory loss, unusual behavior, personality changes, and a decline in thinking abilities. These losses relate to the death of brain cells and the breakdown of the connections between them.

The disease is the most common form of dementing illness among middle and older adults, affecting more than 4 million Americans and many millions worldwide. The prevalence of Alzheimer's among adults ages 70-79 in India, however, is 4.4 times less than the rate in the United States.

Widely used as a food dye and preservative, and in some cancer treatments, curcumin has undergone extensive toxicological testing in animals. It also is used extensively in traditional Indian medicine to treat a variety of ailments.

Other members of the research team are Fusheng Yang, Giselle Lim, Aynun Begum, Mychica Simmons, Suren Ambegaokar, Ping Ping Chen of UCLA; Rakez Kyad and Charlie Glabe of the University of California at Irvine; and Sally Frautschy of UCLA and the Greater Los Angeles VA Healthcare System at Sepulveda.

The Alzheimer Disease Research Center at UCLA, directed by Dr. Jeffrey L. Cummings, was established in 1991 by a grant from the National Institute on Aging. Together with grants from the Alzheimer's Disease Research Center of California and the Sidell-Kagan Foundation, the center provides a mechanism for integrating, coordinating and supporting new and ongoing research by established investigators in Alzheimer's disease and aging.

Veterans Affairs Greater Los Angeles Health Care System and Sepulveda Ambulatory Care Center combine resources to form a unified Geriatric Research Education and Clinical Center, one of 20 nationwide. These centers of excellence are designed to improve health care and quality of life to older veterans through the advancement and integration of research, education and clinical achievements in geriatrics and gerontology into the total VA health care system and broader communities.http://www.ucla.edu/

Friday, April 6, 2007

THE DEMOGRAPHIC transition happening in India is striking. Fifteen years ago, of the 820 million people in the country, about 8.5 per cent (or 70 million people) were over 60 years of age. Today, the proportion of these geriatrics has increased to 10 per cent, and by the year 2021, every seventh Indian will be a senior citizen.

This ageing of India poses health issues of a kind not as pronounced a generation ago. With age come problems of ageing disorders and diseases. The most challenging of these is the set of neurodegenerative diseases, notably dementia or loss of mental functions.

Increasingly prevalent Alzheimer's disease, or senile dementia, is an increasingly prevalent form of these. The Kerala-based Alzheimer's and Related Disorders Society of India (ARDSI) has been doing praiseworthy work in recognising this growing geriatric problem and suggesting ways and means of tackling it, including starting a Respite Care Centre for Alzheimer's disease patients.

The disease is named after the German physician Alois Alzheimer who described its symptoms and pathology about 100 years ago, when he was treating an elderly lady who was progressively losing memory, speech, displaying hallucinations and delusions, and finally became totally helpless. Autopsy of her brain showed strands of thick, insoluble deposits, which presumably interfered with normal brain function, by disturbing the electrical activity there. (Interesting how some diseases are named after the doctor who described them while some others are named after the patient who suffers from them, e. g., Lou Gehrig disease, after the baseball hero).

Cause not clearWhat causes these Alzheimer's plaques is not clear, but a variety of factors seem to do so. Mutations or variants of the gene for the blood protein called Apolipoprotein E (ApoE) are associated with the disorder.

Life-style habits, diet and drugs are known to be involved as well. The mere process of ageing is a factor — hence the name senile dementia.

How can we affect the course of human ageing? The clue stares us in the face when we ask the opposite question — what hastens ageing? Smoking, drinking, bad eating habits and impaired nutrition, abuse of the body through lack of exercise, excessive exposure to the sun and the elements and such do.

Gymnasts, health clinicians and yoga teachers show us how controlling our diet and habits, and regular physical exercise keeps the body young.Taking care of the body helps it keep young. Look at the 36-year-old Andre Agassi, who rebirthed himself in world tennis for the second time and almost won the US open this year, more than a decade later.Or the bicycling hero Lance Armstrong, who became the champion of the Tour de France after successfully overcoming testicular cancer.

If physical exercise and proper habits can delay the course of physical ageing, why can we not do the same about mental ageing or senility? Gratifyingly, the answer seems to be in the affirmative. Mental exercise appears to affect the course of mental ageing in desirable ways.Herein lies the hope for Alzheimer's and related conditions of dementia. There is now increasing evidence that an intellectually stimulating lifestyle may help modify late-life mental health in a positive manner.

Dr. R. Katzman asked in 1995, in an issue of the Journal of the American Geriatrics Society, whether late-life social and leisure activities delay the onset of dementia.

Testing the ideaThe question was posed in order to focus attention of the increasing hints that lifestyle can delay mental ageing, and to provoke studies to test the idea. Since then, several papers have appeared, supporting the idea. In an article titled `Exercise, experience and the aging brain', in the journal Neurobiology of Ageing three years ago, J.D. Churchill and others suggest that "mental exercise provided by frequent engagement in intellectually demanding activity at work may facilitate the maintenance of inherent cognitive reserve, leading to more sophisticated cerebral networks in old age".

Latest paper Dr. L. Fratiglioni and coworkers note in Lancet Neurology last year that an active and socially integrated life style in late life might protect against dementia.The latest in the series of papers is a detailed population-based study of thousands of twins, all of them senior citizens, from Sweden. There is an inherent advantage in studying twins — they share the same genes, so that we can study the effect of `nurture', and not worry about factors of `nature', particularly with identical twins. Dr. Ross Andel of the University of South Florida has collaborated with colleagues in Sweden and analysed the connection between the incidence of Alzheimer's in these twins and their education, work pattern and the complexity of the work they had been involved in.

This is a classic `co-twin' study, where one of the twins has the disease while the other does not. In addition, they compared demented individuals with non-demented ones in a case-control study.

Complexity of the work involved demands on working with data, with people, and with things.

Working with people involved teaching or mentoring, negotiating, supervising, persuading, serving and such.

The results, published in the September issue of the Journal of Gerontology, suggest that greater complexity of work, and particularly complex work with people, may reduce the risk of Alzheimer's disease.

What then is the take-home message?Bend your brain so that you keep it in good order. Play with children, take up a new hobby, do crossword puzzles, solve Sudoku, learn a new language, interact with people — whatever! These are tonics for the mind and easy and enjoyable.

In contrast to many other cultures, where dementia is not seen as a particularly significant public health problem, modern Western societies seem intolerant. Industrial societies increasingly emphasise youth, productivity, self-control, and self-centred attitudes - 'I'm worth it'.

Global telecommunications and the age of the computer have placed greater worth on technology and, in relation to this, the way the brain functions. Cognitive psychology orginally had a particularly intimate relationship with computer science. The emphasis on memory, problem solving, reasoning, calculation, capacity and storage provided a particularly useful analogy for how the brain might work. As we embrace technology more and more it is easy to see the relative ease with which we associate worth with ease of functionality.With the loss or lack of cognitive skills comes the danger of a new form of prejudice against those who don't function properly.

Such is the respect given to computers that Turkle (1984) described them a form of 'second self' for much of the population. Any slight deviation, even mild changes associated with old age, have become pathologized. If it can't be fixed then it isn't valuable and perhaps should really be discarded.

What might we learn from other cultures? In China, itself an advancing technological nation, a certain level of 'childish' behavior is accepted in the very old and is not seen as a reason for treatment. In India, dementia is either less severe or less frequent, because there is greater tolerance. Neither country is perfect and abuse of the elderly does exist. Perhaps we can step back a little and learn that industrial-based cultures don't have to be intolerant. Hopefully as countries such as China and India progress, they won't choose to learn their intolerance from us.

Thursday, April 5, 2007

NEW DELHI: New research conducted in the US says that staying active socially may help prevent Alzheimer's disease in the elderly. Alzheimer's, which is a progressive brain disorder that gradually destroys a person’s memory and ability to reason and make judgments, affects 5% of the population above the age of 60 in India.

According to David Bennett and his team from Rush University Medical Centre, loneliness increases the chances of having Alzheime's symptoms.

The team followed 823 people in and around Chicago with an average age of 80, none of whom had dementia at the start of the study.

Over the past four years, researchers asked the participants about their social activity — whether they felt they had enough friends, whether they felt abandoned or experienced a sense of emptiness. They were given scores between 0 (least lonely) and 5 (most lonely).

During the study, 76 people developed Alzheimer's. Those who did were more likely to have poor social networks. Those with a score of 3.2 or more (the loneliest 10%) had double the risk of those scoring below 1.4.

This study of the old man's disease proves to be of prime importance for India where by 2050, the average Indian might live from the current 64.7 years to 75.6 years.

Dr J D Mukherji, HoD (neurology) at Max Super Specialty Hospital, said, "Besides genetic factors, mental, physical and social activities are being seen as protective factors against Alzheimer’s. Symptoms such as minor forgetfulness and improper language functions aren't understood by family members, leading to the patient feeling isolated. India, which is ageing, needs to have proper caretaker groups who can understand these patients and help them through a fresh re-learning process.

" Dr Sanjay Saxena of Fortis Hospital, Noida, added, "A patient with Alzheimer's undergoes personality changes as the disease progresses. Loneliness leads to behavioural problems. Such patients are prone to go into dementia. The caretaker plays a very important part in the patient’s well-being. The patient needs to interact more and feel wanted.

" According to the 2006 World Population Prospects, by the UN Department of Economic and Social Affairs,by 2050, the number of Indians aged above 80 will increase more than six times from the current number of 78 lakh to nearly 5.14 crore. At present, 20% of this category in India suffer from Alzheimer's. The number of people over 65 years of age in the country is expected to quadruple from 6.4 crore in 2005 to 23.9 crore, while those aged 60 and above will increase from 8.4 crore to 33.5 crore in the next 43 years.

Dr Kameshwar Prasad, professor of neurology at AIIMS, said, "Social stigma against Alzheimer's, that is rampant in India, has to be eliminated.There is tremendous lack of awareness about the disease both among the population at large and care givers. With India ageing, the number of trained care givers has to increase substantially." According to one estimate, Alzheimer's kills one out of four Indians over the age of 80. The early stage of Alzheimer's is often overlooked and incorrectly labelled as normal old age outcomes.